Thuroid & Diabetes Flashcards
(124 cards)
0
Q
MOA thioureylens
Carbimbazine & PTU
A
Blocks enzyme which synthesise thyroid hormones
PTU also prevent T4-T3 conversion in peripheral tissue
1
Q
First line agents against hyperthyroidism
A
Thioureylenes
Carbimazole
Propylthiouracil PTU
2
Q
What is the drug of choice in hypothyroidism?
A
Thyroxine T4 (synthetic)
3
Q
Insulin
A
2 amino acid chains produced & stored in Beta cell in islet of langerhans in the pancreas
4
Q
Hyperglycaemia
A
Elevated glucose levels
5
Q
HbA1c
A
Glycated haemoglobin
6
Q
Diabetes is
A
A metabolic disorder characterised by chronic hyperglycaemia with disturbance of carbohydrate, fat & protein metabolism resulting from defects in insulin secretion, lack of insulin sensitivity or both
7
Q
Normal BGL
A
3.5-8mmol/L
8
Q
Action of insulin
A
- Increase glucose and amino acid uptake by muscle, liver and adipose tissue
- increases protein synthesis, glycogenesis, loop genesis RNA &DNA synthesis intracellular action(growth)
- reduces glucose output, glyconeogenesis, proteolysis & lipolysis
9
Q
First line oral hypoglycaemic agents in type 2 diabetes treatment
A
Metformin
Biguanides
10
Q
Second line oral hypoglycaemic agent in the treatment of diabetes 2
A
Sulfonylureas
11
Q
Sulfonylureas action
A
Closes K+ ATP channel stimulates release of insulin from beta cells in pancreas
12
Q
HbA1C
A
Below 7% significantly reduces risk of complications
13
Q
Haemersiderin deposits
A
Painful, itchy, dry brown iron deposits
Anterior tibia
14
Q
How do we treat a bacterial infection where MRSA is present?
A
Vancomycin
15
Q
When must you give people diabetes education?
A
Every time they come into clinic
16
Q
Pharmacological anxiety treatments
A
Benzodiazepines
Antidepressants
Antipsychotics
17
Q
Role of GABA
A
Inhibitory neurotransmitter in the CNS
18
Q
MOA benzodiazepines
A
Bind to GABAa receptor –> greater response to GABA –> reduced anxiety
19
Q
SSRI
A
Selective serotonin re-uptake inhibitors
20
Q
SNRIs
A
Serotonin & noradrenalin re-uptake inhibitors
21
Q
TCAs
A
Tricyclic antidepressants
22
Q
MOA-Is
A
Monoamine oxidase inhibitors
23
Q
Non pharmacological treatments of depression
A
Monitor Educate Supportive counselling Guided self-help Behavioural techniques Psychotherapy Physical exercise & lifestyle change
24
SSRIs MOA
Selective serotonin re uptake inhibitor: Selectively inhibits presynaptic re-uptake of serotonin into nerve terminal
25
SNRIs MOA
Serotonin & noradrenalin re-uptake inhibitors: inhibit serotonin and noradrenalin re uptake
26
TCAs MOA
Tricyclic antidepressants: inhibit noradrenaline & serotonin uptake (to presynaptic terminals)
Also blockcholinergic, histaminic, alpha receptors --> ADRs
27
MAO-I MOA
Monoamine oxidase inhibitors
| Irreversibly inhibit an enzyme MAO-A and MAO-B increasing concentration of all amines
28
Simvastatin MOA
HMG-CoA reductase inhibitor
29
Alpha glucose inhibitor example and MOA
(Acarbose) inhibits the enzyme in the small intestine and delays digestion & absorption of polysaccharide carbohydrates
30
Glitazones examples and MOA
(Thiazoledinediones)
Pioglitazone
Rosiglitazone
Increases sensitivity in peripheral tissues to insulin, regulates glucose and lipid metabolism, decreases glyconeogenesis (liver glucose output)
31
Gliptins
| DPP4 inhibitors
Inhibit DDP enzyme - increase in retain levels & beta cells glucose sensitivity
--> increase glucose dependant insulin secretion --> decrease glucagon & so decrease glucose production --> increase insulin synthesis
32
Incretin analogues
| Example and MOA
Exenatide, litaglutide
- increase glucose dependant insulin secretion
- decrease inappropriate glucagon secretion
- delays gastric emptying, rate of glucose absorption and reduces appetite
33
Biguanides
| Example & MOA
Metformin
- decrease glucose production
- increase glucose uptake by AMP-K activity in cell membrane
- reduce glucose absorption
- increase fatty acid oxidation
- increase sensitivity & binding
34
First line treatment for diabetes
Biguanides
| Metformin
35
Sulfonylureas
| Example and MOA
Glibenclamide, clipzide, gliclazide, glimepiride
| Closes K+ATP channel stimulates release of insulin from beta cells in pancreas
36
Sulfonylureas
| Can
Reduce insulin resistance
Or
Increase insulin sensitivity
37
Cramping is due to
Ischaemia
| Intermittent claudication
38
Clotting factors
Proteolysis proteins made in the liver
39
Warfarin
Is an anticoagulant/anti thrombotic.
Works by inhibiting the synthesis of vitamin k dependant coagulation factors
(Coumadin, Marevan)
40
Miconazole
Daktarin
41
Lamisil
Active ingredient
Class
MOA
Terbinafine is an allylamine
Broad spectrum antifungal
Blocks the biosynthesis of ergosterol resulting in an accumulation of squalene
42
What is leukonychia
White marking on the nail
Striata
Punctata
Totalis
43
Step 1 on the pain ladder
Non-opioid
| +/- adjuvant
44
Step 2 on the pain ladder
Opioid +/- non-opioid +/- adjuvant
45
Step 3 on the pain ladder
Opioid +/- non opioid +/- adjuvant
46
Ester and amide LA clinically relevant differences
Esters are metabolised more quickly
| Therefore shorter duration of action
47
3 characteristics of COPD treatment
Improve exercise tolerance
Symptom relief
Maintain or improve
Prevent or treat exacerbation a and complications
48
3 adjuvants used for pain management
```
GABA analogues
Capsaicin
Tricyclics antidepressants
Corticosteroids
Psychotropic drugs
```
49
What are symptom controllers for treatment of asthma?
LABA
50
Clinical types of pain
Nociceptive pain
Neuropathic pain
Mixed pain
51
What micro organisms are associated with ecthyma
Streptococcus & pseudomonas
52
Different types of DMARDS
```
Gold salts
Penicillamine
Sulfasalazine
Hydrochloroquine
TNF-alpha antagonists
Immunosuppressants
Cytokine modulators
```
53
Examples of gold salts
Auranofin & aurothiomalate
54
Penicillamine
| Action
Reduces T-cells activity & reduces rheumatoid factor & immune complexes in blood & joints
55
Sulfasalazine
| MOA
Modifies lymphocyte proliferation
| & reduces cytokines
56
First line treatment in early rheumatoid arthritis
Methotrexate
| Antimetabolite antineoplastic agent
57
Onycholysis possible aetiologies
```
Idiopathic
Systemic (PAD, iron deficiency anaemia)
Cutaneous disease(psoriasis, eczema, hyperhidrolosis)
Local causes (trauma, infection, exposure to irritants)
```
58
In case of a penicillin allergy what is commonly used
Cephalosporins
59
Allopurinol MOA
Reduces uric acid production by inhibiting a converting enzyme which converts purines to uric acid
(Reduces plasma and urinary irate levels)
60
Name 3topical antifungal nail lacquer
Amorolfine- loceryl
Bifonazole- canestan nail treatment
Ciclopirox- rejuvenail
61
What is used to treat Methicillin resistant staphycoccus aureus?
MRSA
| Vancomycin- inhibits bacterial cell wall synthesis (glucopeptide)
62
Prednisone
Corticosteroid
63
Corticosteroid MOA
Regulate gene expression suppressing inflammation & immune response as well as glucose, protein & lipid metabolism.
Mimic action of body's own steroids.
64
Uniform thickening of the nail
Onychauxis
65
Three types of involuted nails
Tile shaped
Plicatured
Pincer
66
Onychogryphosis
Nail plate grossly thickened & curved
| May have longitudinal or transverse ridges
67
Onychomycosis
Fungal infection of nail bed and nail plate
Involves dermatophytes metabolising keratin
Causes nail plate to thicken and discolour
68
Onycholysis
Separation of the nail from the nail bed at distal end &/or lateral margins
Detachment of nail plate leads to greyish-white colour
69
Spontaneous separation of the nail
| From matrix to free edge
Onychomadesis
70
Nail penetrates dermis in sulci
Onychocyptosis
71
Tranexamic acid
| MOA
Blocks binding plasminogen & plasminogen to fibrin
| - inhibits breakdown of clots
72
Vitamin K antagonists
| MOA examples
Inhibit enzymatic synthesis of vitamin K dependent clotting factors & the anti thrombin factors proteins C & S
Warfarin (coumadin, marevan)
Phenindione (dindevan)
73
Anticoagulants
Heparin
Enoxaparin
Dalteparin
Danaparoid
74
MOA of heparin
Inactivate thrombin IIa and clotting factor XA by binding to antithrombin III
75
Antiplatelet agents
```
Aspirin
Dipyridamole
Ticagrelor
Thienopyridines
Glycoprotein IIb/IIIa inhibitor
```
76
Aspirin MOA
Irreversibly inhibit cyclo-oxygenase --> inhibit thromboxane A2 production --> blocks platelet aggregation for life of platelet
77
Thrombolytics
| MOA
Converts plasminogen to plasminogen which catalyses breakdown of fibrin
78
Internal normalised ratio
Time taken for blood to clot using a standardised test.
79
High INR is indicative of
The longer it will take blood to clot
| Risk of bleeding
80
Lower the INR
More likely to form a blood clot
81
INR normal value
0.8-1.2
82
Prothrombin time
PT - is also a measure of how long it takes blood to clot
83
Target INR for people taking warfarin
2-3
84
Onychophosis
HK or heloma durum in the nail sulcus
85
Lipitor
| Class & MOA
Hypolipidaemic agent - atorvastatin
| MOA - HMG-CoA reductase inhibitor
86
First line treatment for acute gout
Indomethacin (NSAID)
Or
Colchicine (if NSAID is contraindicated)
87
Recurrent gout treatment
Allopurinol plus either colchicine or NSAID then allopurinol alone
88
Chronic gout treatment
Difficult to treat
| Colchicine and/or indomethacin are introduced slowly
89
First line treatment of rheumatoid arthritis
Methotrexate as mono therapy OR in combination with DMARDs
90
Allopurinol
| MOA
Inhibits xanthine oxidase which catalyses the conversion of hypoxanthine to xanthine & then xanthine to urate/uric acid
91
Pale dendritic cells responsible for immunological responses of skin to environmental antigens
Langerhans cells
92
Melanocytes
Produce pigment & UV protection
93
Merkel cells
Associated with nerve fibre - play a sensory function
94
Specialised skin Cell with branching process
Melanocytes
95
Pacinian corpuscule
Detect pressure & high frequency vibrations; largest of encapsulated nerve endings
96
Ruffini endings detect
Heavy and continuous touch sensations & pressure
97
Meissner's corpuscle
Detect touch and low frequency vibration
98
Merkel's disc
Is primarily involved in touch
99
Nerve supply of the skin
Autonomic nerves supply the blood vessels, sweat glands and arrector pili muscles
100
Apocrine sweat glands
Larger than eccrine glands
| Most numerous around axillae, perineum, areolae
101
Eccrine sweat gland
Excretory duct spirals upward to open onto skin surface
| Most on palms, soles, axillae & forehead
102
Sweat glands
Tube like, cooled glands, located within the dermis
Produce a watery secretion
Two types: eccrine & apocrine
103
Sebaceous gland
Form around hair follicle and secrete sebum
104
What is the process of the entire cell being shed as a secretory product
Holocene process
105
Papillary dermis
Closer to the surface- highly vascular & has a thin network of collagen fibres
106
How does penicillin work?
Inhibit cell wall synthesis
107
How does an ACE inhibitor lower BP
Blocks conversion of angiotensin I to angiotensin II which results in reduce vasoconstriction & reduced BP. Also reduces aldosterone release lowering sodium and water resorption reducing BP
108
What causes gout?
Hyperuricaemia either
| Decreased excretion of uric acid or increased production of uric acid
109
What would you use to treat Candida albicans and trichopyton rubrum?
Lamisil (terbinafine) or daktarin (azole)
| As they are active against both organisms
110
Terbinafine & azole a work by
Inhibit cell wall synthesis by inhibiting ergosterol synthesis
111
Yellow pus on a bacterial infection is indicative of
S. Aureus
112
Mupirocin
Inhibits bacterial protein synthesis
| By reversible and specifically binding to transfer RNA synthase
113
First line treatment for dyslipidemia
Diet
114
The name given to an infection that occurs during antimicrobial treatment
Superinfection
115
Causative organisms for tinea pedis
Candida albicans & trichopyton rubrum
116
Green fruity Purulent exudate, what micro organism would you suspect?
Pseudomonas
117
What is treatment of choice for mild impetigo on the leg?
Mupirocin (Bactroban)
118
4 mechanisms of antibiotics
Inhibit bacterial cell wall synthesis
Inhibit protein synthesis
Inhibit DNA synthesis
Disrupt or alter cell membrane permeability
119
Erythromycin
| MOA
Macro life antibiotic
Inhibits protein synthesis
120
First line pharmacological treatment for congestive heart failure
Ace inhibitor
121
Glucosamine
Natural supplement derived from shellfish
Thought to inhibit pro-inflammatory mediators in the development of OA
122
What do you tell a patient who is using Tea tree oils instead of medicament
Has not been demonstrated to be consistently effective
123
Paracetamol
| MOA
Inhibit prostaglandin synthesis in CBS by inhibiting cox-3
